Chapter 05: Pain Assessment and Management in Children
Chapter 05: Pain Assessment and Management in Children
MULTIPLE CHOICE
- Which is the most consistent and commonly used data for assessment of pain in infants?
| a. | Self-report |
| b. | Behavioral |
| c. | Physiologic |
| d. | Parental report |
ANS: B
Behavioral assessment is useful for measuring pain in young children and preverbal children who do not have the language skills to communicate that they are in pain. Infants are not able to self-report. Physiologic measures are not able to distinguish between physical responses to pain and other forms of stress. Parental report without a structured tool may not accurately reflect the degree of discomfort.
DIF: Cognitive Level: Understanding REF: p. 152
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group?
| a. | “No hurt.” |
| b. | “Red pain.” |
| c. | “Zero hurt.” |
| d. | “Least pain.” |
ANS: A
“No hurt” is a phrase that is simple, concrete, and appropriate to the preoperational stage of the child. Using color is complicated for this age group. The child needs to identify colors and pain levels and then choose an appropriate symbolic color. This is appropriate for an older child. Zero is an abstract construct not appropriate for this age group. “Least pain” is less concrete than “no hurt.”
DIF: Cognitive Level: Applying REF: p. 154
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- What is an important consideration when using the FACES pain rating scale with children?
| a. | Children color the face with the color they choose to best describe their pain. |
| b. | The scale can be used with most children as young as 3 years. |
| c. | The scale is not appropriate for use with adolescents. |
| d. | The FACES scale is useful in pain assessment but is not as accurate as physiologic responses. |
ANS: B
The FACES scale is validated for use with children ages 3 years and older. Children point to the face that best describes their level of pain. The scale can be used through adulthood. The child’s estimate of the pain should be used. The physiologic measures may not reflect more long-term pain.
DIF: Cognitive Level: Applying REF: p. 154
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- What describes nonpharmacologic techniques for pain management?
| a. | They may reduce pain perception. |
| b. | They usually take too long to implement. |
| c. | They make pharmacologic strategies unnecessary. |
| d. | They trick children into believing they do not have pain. |
ANS: A
Nonpharmacologic techniques provide coping strategies that may help reduce pain perception, make the pain more tolerable, decrease anxiety, and enhance the effectiveness of analgesics. The nonpharmacologic strategy should be matched with the child’s pain severity and be taught to the child before the onset of the painful experience. Tricking children into believing they do not have pain may mitigate the child’s experience with mild pain, but the child will still know the discomfort was present.
DIF: Cognitive Level: Analyzing REF: pp. 163-164 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain?
| a. | Tactile stimulation |
| b. | Commercial warm packs |
| c. | Doing procedure during infant sleep |
| d. | Oral sucrose and nonnutritive sucking |
ANS: D
Nonnutritive sucking attenuates behavioral, physiologic, and hormonal responses to pain. The addition of sucrose has been demonstrated to have calming and pain-relieving effects for neonates. Tactile stimulation has a variable effect on response to procedural pain. No evidence supports commercial warm packs as a pain control measure. With resulting increased blood flow to the area, pain may be greater. The infant should not be disturbed during the sleep cycle. It makes it more difficult for the infant to begin organization of sleep and awake cycles.
DIF: Cognitive Level: Analyzing REF: p. 165 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?
| a. | The child will continue to sleep and be pain free. |
| b. | Parents cannot administer additional medication with the button. |
| c. | The pump can deliver baseline and bolus dosages. |
| d. | There is a high risk of overdose, so monitoring is done every 15 minutes. |
ANS: C
The PCA prescription can be set for a basal rate for a continuous infusion of pain medication. Additional doses can be administered by the patient, parent, or nurse as necessary. Although the goal of PCA is to have effective pain relief, a pain-free state may not be possible. With a 6-year-old child, the parents and nurse must assess the child to ensure that adequate medication is being given because the child may not understand the concept of pushing a button. Evidence-based practice suggests that effective analgesia can be obtained with the parents and nurse giving boluses as necessary. The prescription for the PCA includes how much medication can be given in a defined period. Monitoring every 1 to 2 hours for patient response is sufficient.
DIF: Cognitive Level: Applying REF: p. 176
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
- Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
| a. | Codeine sulfate (Codeine) |
| b. | Morphine (Roxanol) |
| c. | Methadone (Dolophine) |
| d. | Meperidine (Demerol) |
ANS: B
The most commonly prescribed medications for PCA are morphine, hydromorphone, and fentanyl. Parenteral use of codeine is not recommended. Methadone in parenteral form is not used in a PCA but is given orally or intravenously for pain in the infant. Meperidine is not used for continuous and extended pain relief.
DIF: Cognitive Level: Analyzing REF: p. 176
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?
| a. | Give only an opioid analgesic at this time. |
| b. | Increase dosage of analgesic until the child is adequately sedated. |
| c. | Plan a preventive schedule of pain medication around the clock. |
| d. | Give the child a clock and explain when she or he can have pain medications. |
ANS: C
For severe postoperative pain, a preventive around the clock (ATC) schedule is necessary to prevent decreased plasma levels of medications. The opioid analgesic will help for the present, but it is not an effective strategy. Increasing the dosage requires an order. The nurse should give the drug on a regular schedule and evaluate the effectiveness. Using a clock is counterproductive because it focuses the child’s attention on how long he or she will need to wait for pain relief.
DIF: Cognitive Level: Implementation REF: p. 176 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurse’s response should be based on which characteristic about preterm infants’ pain?
| a. | They may react to painful stimuli but are unable to remember the pain experience. |
| b. | They perceive and react to pain in much the same manner as children and adults. |
| c. | They do not have the cortical and subcortical centers that are needed for pain perception. |
| d. | They lack neurochemical systems associated with pain transmission and modulation. |
ANS: B
Numerous research studies have indicated that preterm and newborn infants perceive and react to pain in the same manner as children and adults. Preterm infants can have significant reactions to painful stimuli. Pain can cause oxygen desaturation and global stress response. These physiologic effects must be avoided by use of appropriate analgesia. Painful stimuli cause a global stress response, including cardiorespiratory changes, palmar sweating, increased intracranial pressure, and hormonal and metabolic changes. Adequate analgesia and anesthesia are necessary to decrease the stress response.
DIF: Cognitive Level: Analyzing REF: p. 153
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
- A preterm infant has just been admitted to the neonatal intensive care unit. The infant’s parents ask the nurse about anesthesia and analgesia when painful procedures are necessary. What should the nurse’s explanation be?
| a. | Nerve pathways of neonates are not sufficiently myelinated to transmit painful stimuli. |
| b. | The risks accompanying anesthesia and analgesia are too great to justify any possible benefit of pain relief. |
| c. | Neonates do not possess sufficiently integrated cortical function to interpret or recall pain experiences. |
| d. | Pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates. |
ANS: D
Pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates. Painful stimuli cause a global stress response, including cardiorespiratory changes, palmar sweating, increased intracranial pressure, and hormonal and metabolic changes. Adequate analgesia and anesthesia are necessary to decrease the stress response. The pathways are sufficiently myelinated to transmit the painful stimuli and produce the pain response. Local and systemic pharmacologic agents are available to permit anesthesia and analgesia for neonates.
DIF: Cognitive Level: Analyzing REF: p. 185
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
- A bone marrow aspiration and biopsy are needed on a school-age child. The most appropriate action to provide analgesia during the procedure is which?
| a. | Administer TAC (tetracaine, adrenalin, and cocaine) 15 minutes before the procedure. |
| b. | Use a combination of fentanyl and midazolam for conscious sedation. |
| c. | Apply EMLA (eutectic mixture of local anesthetics) 1 hour before the procedure. |
| d. | Apply a transdermal fentanyl (Duragesic) “patch” immediately before the procedure. |
ANS: B
A bone marrow biopsy is a painful procedure. The combination of fentanyl and midazolam should be used to provide conscious sedation. TAC provides skin anesthesia about 15 minutes after it is applied to nonintact skin. The gel can be placed on a wound for suturing. It is not sufficient for a bone marrow biopsy. EMLA is an effective topical analgesic agent when applied to the skin 60 minutes before a procedure. It eliminates or reduces the pain from most procedures involving skin puncture. For this procedure, systemic analgesia is required. Transdermal fentanyl patches are useful for continuous pain control, not rapid pain control.
DIF: Cognitive Level: Analyzing REF: p. 185
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- What is a significant common side effect that occurs with opioid administration?
| a. | Euphoria |
| b. | Diuresis |
| c. | Constipation |
| d. | Allergic reactions |
ANS: C
Constipation is one of the most common side effects of opioid administration. Preventive strategies should be implemented to minimize this problem. Sedation is a more common result than euphoria. Urinary retention, not diuresis, may occur with opiates. Rarely, some individuals may have pruritus.
DIF: Cognitive Level: Remembering REF: p. 171 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- The nurse is caring for a child receiving a continuous intravenous (IV) low-dose infusion of morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to do which first?
| a. | Administer naloxone (Narcan). |
| b. | Discontinue the IV infusion. |
| c. | Discontinue morphine until the child is fully awake. |
| d. | Stimulate the child by calling his or her name, shaking gently, and asking the child to breathe deeply. |
ANS: A
The management of opioid-induced respiratory depression includes lowering the rate of infusion and stimulating the child. If the respiratory rate is depressed and the child cannot be aroused, then IV naloxone should be administered. The child will be in pain because of the reversal of the morphine. The morphine should be discontinued, but naloxone is indicated if the child is unresponsive.
DIF: Cognitive Level: Applying REF: p. 180
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching?
| a. | “With minimal sedation, the patient’s respiratory efforts are affected, and cognitive function is not impaired.” |
| b. | “With general anesthesia, the patient’s airway cannot be maintained, but cardiovascular function is maintained.” |
| c. | “During deep sedation, the patient can be easily aroused by loud verbal commands and tactile stimulation.” |
| d. | “During moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation.” |
ANS: D
When discussing levels of sedation, the participants should understand that during moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation, cognitive function is impaired, and respiratory function is adequate. In minimal sedation, the patient responds to verbal commands and may have impaired cognitive function; the respiratory and cardiovascular systems are unaffected. In deep sedation, the patient cannot be easily aroused except by painful stimuli; the airway and spontaneous ventilation may be impaired, but cardiovascular function is maintained. With general anesthesia, the patient loses consciousness and cannot be aroused with painful stimuli, the airway cannot be maintained, and ventilation is impaired; cardiovascular function may or may not be impaired.
DIF: Cognitive Level: Analyzing REF: p. 184
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
- The nurse is planning to administer a nonopioid for pain relief to a child. Which timing should the nurse plan so the nonopioid takes effect?
| a. | 15 minutes until maximum effect |
| b. | 30 minutes until maximum effect |
| c. | 1 hour until maximum effect |
| d. | 1 1/2 hours until maximum effect |
ANS: C
Nonsteroidal antiinflammatory drugs (NSAIDs) can provide safe and effective pain relief when dosed at appropriate levels with adequate frequency. Most NSAIDs take about 1 hour for effect, so timing is crucial.
DIF: Cognitive Level: Applying REF: p. 171 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route?
| a. | Less expensive than oral medications |
| b. | Produces a first-pass effect through the liver |
| c. | Does not need to be administered frequently |
| d. | Provides most rapid onset of effect, usually in about 5 minutes |
ANS: D
The advantage of pain medication by the IV bolus route is that it provides the most rapid onset of effect, usually in about 5 minutes. IV medications are more expensive than oral medications, and the IV route bypasses the first-pass effect through the liver. Pain control with IV bolus medication needs to be repeated hourly for continuous pain control.
DIF: Cognitive Level: Applying REF: p. 176 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- The nurse is teaching the parents of a child with recurrent headaches methods to modify behavior patterns that increase the risk of headache. Which statement by the parents indicates understanding the teaching?
| a. | “We will allow the child to miss school if a headache occurs.” |
| b. | “We will respond matter-of-factly to requests for special attention.” |
| c. | “We will be sure to give much attention to our child when a headache occurs.” |
| d. | “We will be sure our child doesn’t have to perform at a band concert if a headache occurs.” |
ANS: B
To modify behavior patterns that increase the risk of headache or reinforce headache activity, the nurse instructs the parents to avoid giving excessive attention to their child’s headache and to respond matter-of-factly to pain behavior and requests for special attention. Parents learn to assess whether the child is avoiding school or social performance demands because of headache.
DIF: Cognitive Level: Applying REF: p. 186
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Physiological Integrity
- Which is a complication that can occur after abdominal surgery if pain is not managed?
| a. | Atelectasis |
| b. | Hypoglycemia |
| c. | Decrease in heart rate |
| d. | Increase in cardiac output |
ANS: A
Pain associated with surgery in the abdominal region (e.g., appendectomy, cholecystectomy, splenectomy) may result in pulmonary complications. Pain leads to decreased muscle movement in the thorax and abdominal area and leads to decreased tidal volume, vital capacity, functional residual capacity, and alveolar ventilation. The patient is unable to cough and clear secretions, and the risk for complications such as pneumonia and atelectasis is high. Severe postoperative pain also results in sympathetic overactivity, which leads to increases in heart rate, peripheral resistance, blood pressure, and cardiac output. Hypoglycemia, decreases in heart rate, and increases in cardiac output are not complications of poor pain management.
DIF: Cognitive Level: Analyzing REF: p. 185
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to be ordered to control anxiety?
| a. | Lorazepam (Ativan) |
| b. | Oxycodone (OxyContin) |
| c. | Fentanyl (Sublimaze) |
| d. | Morphine Sulfate (Morphine) |
ANS: A
A benzodiazepine such as lorazepam is prescribed as an antianxiety agent. Oxycodone, fentanyl, and morphine sulfate are opioid analgesics.
DIF: Cognitive Level: Applying REF: p. 186 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- A cancer patient is experiencing neuropathic cancer pain. Which prescription should the nurse expect to be ordered to control anxiety?
| a. | Lorazepam (Ativan) |
| b. | Gabapentin (Neurontin) |
| c. | Hydromorphone (Dilaudid) |
| d. | Morphine sulfate (MS Contin) |
ANS: B
Anticonvulsants (gabapentin, carbamazepine) have demonstrated effectiveness in neuropathic cancer pain. Ativan is an antianxiety agent, and Dilaudid and MS Contin are opioid analgesics.
DIF: Cognitive Level: Applying REF: p. 189 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
MULTIPLE RESPONSE
- Which are components of the FLACC scale? (Select all that apply.)
| a. | Color |
| b. | Capillary refill time |
| c. | Leg position |
| d. | Facial expression |
| e. | Activity |
ANS: C, D, E
Facial expression, consolability, cry, activity, and leg position are components of the FLACC scale. Color is a component of the Apgar scoring system. Capillary refill time is a physiologic measure that is not a component of the FLACC scale.
DIF: Cognitive Level: Understanding REF: p. 154
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- The nurse is using the CRIES pain assessment tool on a preterm infant in the neonatal intensive care unit. Which are the components of this tool? (Select all that apply.)
| a. | Color |
| b. | Moro reflex |
| c. | Oxygen saturation |
| d. | Posture of arms and legs |
| e. | Sleeplessness |
| f. | Facial expression |
ANS: C, E, F
Need for increased oxygen, crying, increased vital signs, expression, and sleeplessness are components of the CRIES pain assessment tool used with neonates. Color, Moro reflex, and posture of arms and legs are not components of the CRIES scale.
DIF: Cognitive Level: Applying REF: p. 159
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- Which coanalgesics should the nurse expect to be prescribed for pruritus? (Select all that apply.)
| a. | Naloxone (Narcan) |
| b. | Inapsine (Droperidol) |
| c. | Hydroxyzine (Atarax) |
| d. | Promethazine (Phenergan) |
| e. | Diphenhydramine (Benadryl) |
ANS: A, C, E
The coanalgesics prescribed for pruritus include naloxone, hydroxyzine, and diphenhydramine. Inapsine and promethazine are administered as antiemetics.
DIF: Cognitive Level: Applying REF: p. 174 TOP: Nursing Process: Evaluation
MSC: Client Needs: Physiological Integrity
- A child receiving chemotherapy is experiencing mucositis. Which prescriptions should the nurse plan to administer for initial treatment? (Select all that apply.)
| a. | Scope mouth rinse |
| b. | Listerine antiseptic mouth rinse |
| c. | Carafate suspension (Sucralfate) |
| d. | Nystatin oral suspension (Nystatin) |
| e. | Lidocaine viscous (Lidocaine hydrochloride solution) |
ANS: C, D, E
Initial treatment of stomatitis includes single agents (sucralfate suspension, nystatin, and viscous lidocaine). Scope and Listerine are plaque and gingivitis control mouth rinses that would have a drying effect and are not used with mucositis.
DIF: Cognitive Level: Applying REF: p. 188 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
COMPLETION
- A health care provider prescribes promethazine (Phenergan), 9 mg IV every 6 to 8 hours as needed for pruritus. The medication label states: “Promethazine 25 mg/1 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using two decimal places.
________________
ANS:
0.36
Follow the formula for dosage calculation.
Desired
———– ´ Volume = mL per dose
Available
9 mg
———– ´ 1 mL = 0.36 mL
25 mg
DIF: Cognitive Level: Applying REF: p. 174
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes diphenhydramine (Benadryl), 1 mg/kg PO every 4 to 6 hours as needed for pruritus. The child weighs 10 kg. The medication label states: “Diphenhydramine 12.5 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
________________
ANS:
4
Follow the formula for dosage calculation.
Multiply 1 mg ´ 10 kg to get the dose = 10 mg
Desired
———– ´ Volume = mL per dose
Available
10 mg
———– ´ 5 mL = 4 mL
12.5 mg
DIF: Cognitive Level: Applying REF: p. 174
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes hydroxyzine (Atarax), 0.6 mg/kg PO every 4 to 6 hours as needed for pruritus. The medication label states: “Hydroxyzine 10 mg/5 mL.” The child weighs 20 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
________________
ANS:
6
Follow the formula for dosage calculation.
Multiply 0.6 mg ´ 20 kg to get the dose = 12 mg
Desired
———– ´ Volume = mL per dose
Available
12 mg
———– ´ 5 mL = 6 mL
10 mg
DIF: Cognitive Level: Applying REF: p. 174
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A child receiving morphine sulfate (Morphine) is experiencing respiratory depression. A health care provider prescribes naloxone (Narcan), 0.5 mcg/kg IV in 2-minute increments until breathing improves. The medication label states: “Naloxone 400 mcg/1 mL.” The child weighs 40 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using two decimal places.
________________
ANS:
0.05
Follow the formula for dosage calculation.
Multiply 0.5 mcg ´ 40 kg to get the dose = 20 mcg
Desired
———– ´ Volume = mL per dose
Available
20 mcg
———– ´ 1 mL = 0.05 mL
400 mcg
DIF: Cognitive Level: Applying REF: p. 176
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes haloperidol (Haldol), 0.15 mg/kg IV every 4 to 6 hours as needed for confusion. The medication label states: “Haloperidol 2 mg/1 mL.” The child weighs 30 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer rounding to one decimal place.
________________
ANS:
2.3
Follow the formula for dosage calculation.
Multiply 0.15 mg ´ 30 kg to get the dose = 4.5 mg
Desired
———– ´ Volume = mL per dose
Available
4.5 mg
———– ´ 1 mL = 2.25 mL = rounded to one decimal space = 2.3 mL
2 mg
DIF: Cognitive Level: Applying REF: p. 175
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes Kytril (granisetron), 10 mcg/kg IV every 4 to 6 hours as needed for nausea. The medication label states: “Kytril 100 mcg/1 mL.” The child weighs 15 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place.
_______________
ANS:
1.5
Follow the formula for dosage calculation.
Multiply 10 mcg ´ 15 kg to get the dose = 150 mcg
Desired
———– ´ Volume = mL per dose
Available
150 mcg
———– ´ 1 mL = 1.5 mL
100 mcg
DIF: Cognitive Level: Applying REF: p. 174
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes OxyContin (oxycodone), 3 mg PO every 4 to 6 hours as needed for pain. The medication label states: “OxyContin 5 mg/1 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using one decimal place.
________________
ANS:
0.6
Follow the formula for dosage calculation.
Desired
———– ´ Volume = mL per dose
Available
3 mg
———– ´ 1 mL = 0.6 mL
5 mg
DIF: Cognitive Level: Applying REF: p. 172
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes acetaminophen (Tylenol) gtt, 10 mg/kg/dose PO every 4 to 6 hours as needed for pain. The infant weighs 8 kg. The medication label states: “Acetaminophen 80 mg/0.8 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place.
________________
ANS:
0.8
Follow the formula for dosage calculation.
Multiply 10 mg ´ 8 kg to get the dose = 80 mg
Desired
———– ´ Volume = mL per dose
Available
80 mg
———– ´ 0.8 mL = 0.8 mL
80 mg
DIF: Cognitive Level: Applying REF: p. 171
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes naproxen (Naprosyn), 7 mg/kg PO every 12 hours for pain. The child weighs 25 kg. The medication label states: “Naproxen 125 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
________________
ANS:
7
Follow the formula for dosage calculation.
Multiply 7 mg ´ 25 kg to get the dose = 175 mg
Desired
———– ´ Volume = mL per dose
Available
175 mg
———– ´ 5 mL = 7 mL
125 mg
DIF: Cognitive Level: Applying REF: p. 171
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes choline magnesium trisalicylate (Trilisate), 15 mg/kg PO every 8 to 12 hours as needed for pain. The child weighs 10 kg. The medication label states: “Choline magnesium trisalicylate 500 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place.
________________
ANS:
1.5
Follow the formula for dosage calculation.
Multiply 15 mg ´ 10 kg to get the dose = 150 mg
Desired
———– ´ Volume = mL per dose
Available
150 mg
———– ´ 5 mL = 1.5 mL
500 mg
DIF: Cognitive Level: Applying REF: p. 171
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
- A health care provider prescribes ibuprofen (Motrin), 5 mg/kg PO every 6 to 8 hours as needed for pain. The child weighs 8 kg. The medication label states: “Ibuprofen 100 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
________________
ANS:
2
Follow the formula for dosage calculation.
Multiply 5 mg ´ 8 kg to get the dose = 40 mg
Desired
———– ´ Volume = mL per dose
Available
40 mg
———– ´ 5 mL = 2 mL
100 mg
DIF: Cognitive Level: Applying REF: p. 171
TOP: Nursing Process: Implementation MSC: Client Needs: Physiological Integrity
MATCHING
Complementary and alternative medicine therapies are grouped into five classes. Match the complementary or alternative therapy to its classification.
| a. | Vitamins |
| b. | Massage |
| c. | Reiki |
| d. | Hypnosis |
| e. | Homeopathy |
- Manipulative treatment
- Energy based
- Alternative medical system
- Mind–body technique
- Biologically based
- ANS: B DIF: Cognitive Level: Understanding REF: p. 170
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- ANS: C DIF: Cognitive Level: Understanding REF: p. 170
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- ANS: E DIF: Cognitive Level: Understanding REF: p. 170
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- ANS: D DIF: Cognitive Level: Understanding REF: p. 170
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
- ANS: A DIF: Cognitive Level: Understanding REF: p. 170
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity